Severe abdominal pain after a fatty meal may be a sign of gallbladder inflammation

Severe abdominal pain that begins, especially after fatty meals, and lasts for hours may not always be a simple symptom of indigestion as commonly thought. Pain felt in the upper right part of the abdomen that can radiate to the back or right shoulder may be a sign of gallbladder inflammation, medically known as acute cholecystitis.

Dr. İsmail Çalıkoğlu, a General Surgery Specialist at Acıbadem Fulya Hospital, stated that severe abdominal pain accompanied by fever, nausea, and vomiting should not be ignored, and warned that in such cases, one should consult a healthcare facility without delay.

The gallbladder is an organ that stores bile produced by the liver and transfers this fluid to the intestine, especially during the digestion of fatty foods. A disruption in the balance between cholesterol, bile salts, and pigments in the bile content can lead first to biliary sludge and then to gallstones.

If one of the gallstones blocks the gallbladder's outlet duct, bile flow is obstructed. The accumulated bile can cause edema and inflammation in the gallbladder wall. According to Dr. Çalıkoğlu, gallstones are responsible for approximately 90-95 percent of acute cholecystitis cases.

Stating that gallstones are quite common in the community, Çalıkoğlu noted that it is estimated that approximately 10-20 percent of adults have gallstones. While a significant portion of these individuals may not show symptoms, some patients may develop serious problems such as gallbladder inflammation, bile duct obstruction, or pancreatitis.

SYMPTOMS AND RISK FACTORS

The most typical symptom of gallbladder inflammation is pain that begins in the upper right part of the abdomen and gradually intensifies. The pain can often radiate to the right shoulder, under the right shoulder blade, or to the back. Nausea, vomiting, loss of appetite, and fever may also accompany the condition. As the disease progresses, shivering, high fever, and general deterioration of health may be observed.

Gallbladder inflammation is seen approximately 2-3 times more frequently in women than in men. The fact that the estrogen hormone increases the amount of cholesterol in the bile and that gallbladder movements slow down during pregnancy are considered effective in increasing the risk in women.

Advanced age, family history, obesity, diabetes, high cholesterol, prolonged fasting, rapid weight loss, and certain blood diseases are also among the risk factors. Maintaining a healthy weight, regular physical activity, a fiber-rich diet, avoiding prolonged fasting, and avoiding very rapid weight loss can help reduce the risk.

EARLY DIAGNOSIS AND SURGICAL TREATMENT

In diagnosis, the patient's complaints and physical examination findings are evaluated; signs of infection are investigated with blood tests. The first choice in imaging is usually abdominal ultrasonography. With ultrasound, gallstones, thickening of the gallbladder wall, fluid accumulation around it, and findings suggestive of inflammation can largely be detected.

In the first stage of treatment, intravenous fluids, pain control, and antibiotics are administered when necessary. However, medication often does not eliminate the source of the problem. Çalıkoğlu stated that as long as there are stones in the gallbladder, the risk of recurrent inflammatory attacks continues, and that for suitable patients, the permanent treatment is the surgical removal of the gallbladder.

Dr. Çalıkoğlu emphasized that laparoscopic gallbladder surgery performed within the first 72 hours after the onset of symptoms both helps the surgery to be performed more safely and can reduce the length of hospital stay and the risk of complications. Delayed applications can lead to life-threatening consequences such as gangrene in the gallbladder, perforation, widespread peritonitis, and sepsis.